Individual
SUMMER CHANTEL POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7621 N PORTSMOUTH AVE, PORTLAND, OR 97203-5953
(503) 240-7599
Mailing address
2415 SE 43RD AVE, PORTLAND, OR 97206-1600
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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